Groups bash US health care for detained immigrants

by JENNIFER KAY

U.S. immigration authorities routinely delay, deny or botch medical care for detained immigrants in poorly equipped facilities nationwide, according to separate reports released by two advocacy groups Tuesday.

Human Rights Watch and the Florida Immigrant Advocacy Center blame the problems on unskilled or indifferent staff, overcrowding, bureaucratic red tape, language barriers and limited services available to detainees of the U.S. Immigration and Customs Enforcement. The groups contend that many medical problems could be avoided if the agency did not lock up people who are elderly, have health issues or lack criminal records.

Advocates argue that alternatives to detention, like requiring people to check in by phone or in person, are “more humane” and cost taxpayers as little as $12 a day, compared with $95 a day to keep someone in immigration custody.

“ICE needlessly detains people with severe illnesses and those who pose no harm to U.S. communities. Doing so drives up ICE costs even as the agency provides increasingly inadequate medical and mental health care to those in its custody,” said Cheryl Little, FIAC’s executive director.

ICE detained more than 300,000 people in the fiscal year 2007, with a daily average of nearly 30,000. Most were held in state and county jails under contracts with ICE. Some detainees are held for months, even years, though ICE says the average time is 31 days.

The agency responded that its Division of Immigration Health Services gives detainees general and emergency health care, dental, chronic and mental health care.

“ICE is committed to providing all detainees in our care with humane and safe detention environments and ensuring that adequate medical services are provided to all in our care with timely and appropriate treatment,” ICE spokeswoman Nicole Navas said.

In an e-mail, ICE reported that it spent $128 million in 2008 to provide medical and mental health care to its detainees but said there was room to improve. This year, ICE will spend $2 million to review the medical care provided to individuals detained by the Department of Homeland Security.

Current and former detainees complained that medical staff routinely violated their own standards in areas including continuity of care, quick response to medical complaints, informing inmates about the availability of services and providing medical screenings and follow-up care.

Women particularly suffered because routine reproductive care didn’t get adequate attention in a system that emphasized emergency care and treating conditions that might affect detainees’ deportation status, according to Human Rights Watch.

Women told the group’s researchers that they had been shackled while pregnant, missed appointments for mammograms and Pap smears or failed to receive prenatal care while in custody.

“This overall approach, as well as specific restrictions on Pap smears, hormonal contraception, and access to specialist care, undermined the health of a number of women,” according to the Human Rights Watch report.

New Homeland Security Secretary Janet Napolitano has appointed an adviser, Dr. Dora Schriro, to improve the system as growing numbers of immigrants are detained, ICE spokeswoman Barbara Gonzalez said.

Gonzalez said all immigrants in ICE custody can expect a medical screening within 12 hours of admission and a physical exam within two weeks.

Some inmates and former detainees told advocates that they eventually dropped requests for medical care or refused follow-up treatment to avoid being shackled in transit or because they believed their attempts to obtain adequate care were futile. They also reported that security officers inhibited their access to medical care by refusing to call medical staff or violating their privacy by openly discussing their health problems and observing medical exams.

A former detainee who spent 11 months in custody said she and fellow inmates languished without proper care in four different county jails in Florida. Mentally ill women were sent to solitary confinement, sleeping inmates weren’t wakened when medications were distributed and guards refused supplies to menstruating women, said Marlene Jaggernauth, 43, a native of Trinidad. She said her own request to see a gynecologist needed approval from ICE officials in Washington, which never came.

“Part of the problem is that officers are not trained and they don’t really understand what a detainee means,” said Jaggernauth, whose case was finally resolved in June, five years after she was initially detained in 2003. “They think that all immigration detainees are just going to be deported, so they can be ignored.”

Advocates allege that the inadequate care may have contributed to the deaths of some detainees in ICE custody or soon after their release. FIAC’s report cites the deaths of two men whose cancers went untreated, a man whose cardiac infection went untreated, an elderly Haitian minister who was hospitalized in leg restraints after being accused of faking his violent vomiting and a young Haitian man who suffered from seizures and psychiatric problems.

According to ICE, 77 immigrants have died in detention in the last five fiscal years, although it did not specify the causes.

Advocates are not alone in criticizing ICE health care for detainees. The Department of Homeland Security’s Office of Inspector General found instances of noncompliance with medical standards in 2006 and 2008 audits.

On the Net:

Human Rights Watch’s report: http://www.hrw.org/node/81430

FloridaImmigrantAdvocacyCenter: http://www.fiacfla.org/